Individual
CORINNE LEIGH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 823-3951
Mailing address
1842 MCDOWELL ST, AUGUSTA, GA 30904-3861
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1024
SC
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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